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Agency for Healthcare Research & Quality Centers of Excellence

Examining health systems in five regions to understand the role of incentives, use of health IT and organizational integration within systems and its impact on performance and evidence dissemination.

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This effort is part of AHRQ's ongoing work to accelerate the dissemination and implementation of patient-centered outcomes research, or PCOR, findings into practice. The three Centers of Excellence will identify, classify, track and compare health care delivery systems to understand the organizational and environmental factors affecting the use of evidence-based medicine.

The RAND Center of Excellence will examine health systems in five regions with the goal of understanding the role of incentives, use of health IT and organizational integration within systems and its impact on performance and evidence dissemination.

PI:  Dennis Scanlon

Can Risk-Adjusted Emergency Department Utilization Measure Quality or Value in Cancer Care?

Evaluating whether oncology patients’ risk-adjusted ED rates can be used as a hospital-level measure of quality and value of care.

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As the costs of treating cancer continue to soar, several organizations have produced value frameworks to identify and highlight high value treatments that provide a favorable balance of quality and cost. However, few include hospital-based outcomes measures other than survival. This study evaluates  whether oncology patients’ risk-adjusted ED rates can be used as a hospital-level measure of quality and value of care.

PI:  Joel Segel

Diabetes Prevention Program (DPP)

This project, based on the CDC’s national DPP, involves planning and implementing an evidence-based lifestyle intervention to prevent Type 2 diabetes in the State College area

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The year-long intervention involves 16 weekly classes over the course of the first 6 months followed by monthly classes for the remaining 6 months on topics related to diet, exercise, and maintaining a healthy lifestyle. The intervention will be conducted by Penn State Health practitioners in conjunction with researchers from the University and members of the Penn State Office of Human Resources. In addition, Penn State researchers led by a team from HPA and CHCPR will conduct an evaluation to understand the program’s effect on weight loss, blood pressure, glycemic levels, and other relevant clinical outcomes. A known limitation of the national DPP relates to enrollment and retention challenges. To better understand how to improve retention and achievement of DPP clinical goals, the study will also involve a randomized controlled trial where cohorts will be randomized to treatment arms that will include motivational messaging and varying types of financial incentives to incorporate important concepts from the behavioral economics and health communication literature.

PI:  Dennis Scanlon

Estimation of Societal Costs to States Due to Opioid Epidemic

Sponsored by the Pennsylvania Office of Attorney General, this project investigates opioid manufacturer and distributor behavior in influencing the opioid epidemic and to estimates the societal costs borne by states as a result of the epidemic.

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The Penn State team produced a report structured around an overall framework showing the conceptual linkages between alleged behaviors undertaken by opioid manufacturing and distributing companies that may have contributed to the opioid epidemic and the resulting costs borne by states. The team examined the scope of damages from five areas of concern:

1) Health Care Utilization costs

2) Child Welfare and Youth Services costs

3) Criminal Justice costs

4) Education and Special Education costs

5) Employment and Disability costs

Pennsylvania Rural Health Model

Designed in partnership with the Center for Medicare and Medicaid Innovation (CMMI), the Pennsylvania Rural Health Model is an alternative payment model designed to address the financial challenges faced by rural hospitals by transitioning them from fee-for-service to global budget payments.

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The Pennsylvania Rural Health Model aligns incentives for providers to deliver value-based care and provides an opportunity for rural hospitals to transform the care they deliver to better meet community health needs by improving population health outcomes and quality of care while lowering costs.

CHCPR will be conducting a formative evaluation of the Rural Health Model utilizing qualitative and quantitative methodology and will be providing project management leadership for the project.

Pennsylvania Sexual Assault Forensic Examination Training (SAFE-T) Center

Enhancing access to high-quality sexual assault care in underserved communities, the SAFE-T Center was launched with support from the Department of Justice, Office for Victims of Crime as a solution.

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When a sexual assault examination is performed at one of our partner hospitals, one of SAFE-T Center’s expert nurses participates through telehealth. The expert nurse appears on a screen where she can talk to, and support, both the on-site nurse and the victim. Though our specialized digital telehealth technology, she can also see the live exam in progress, ensuring best practices, proper evidence collection and a safe, helpful environment for the victim.

PI: Sheridan Miyamoto

Use of New Hepatitis C Drugs and Patients' Health Outcomes in Medicare

Examining use of new HCV drugs and the effects of those drugs on patients’ health outcomes in Medicare.

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New drugs to treat hepatitis C virus (HCV) are innovative, but their high prices impose financial pressures on the health care system. A debate is ongoing over how to prioritize those treatments. This project examines use of new HCV drugs and the effects of those drugs on patients’ health outcomes in Medicare while providing important information needed to develop coverage decisions and policies to ensure patients’ access to needed drugs while managing spending.

PI:  Jeah Jung